Leisurely walking, even for more than an hour each day, had no preventive effect on the risk of developing metabolic syndrome.

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TUESDAY, Oct. 9, 2012 (MedPage Today)
— An exercise regimen that focuses on intensity rather
than duration of activity can significantly lower the risk for the
constellation of cardiovascular risk factors known as metabolic syndrome,
Danish researchers found.

For instance, brisk walking halved the risk that metabolic syndrome
would develop over a 10-year period, according to Eva Prescott, MD, DSc, and
colleagues from Bispebjerg University in Copenhagen.

In contrast, leisurely walking, even for more than an hour each day,
had no preventive effects, the researchers reported online in BMJ
Open.

Previous cross-sectional studies have suggested that physical activity
can reduce the risks for components of metabolic syndrome such as obesity and
insulin resistance, but longitudinal studies have had conflicting
results.

To clarify this, Prescott and colleagues conducted a study that
included both cross-sectional and longitudinal analyses using data from the
Copenhagen City Heart Study.

For the cross-sectional analysis, they included 10,135 individuals
evaluated between 1991 and 1994, while the longitudinal analysis included 3,992
seen between 2001 and 2003.

Metabolic syndrome was defined as having at least three of the
following: central obesity, high triglycerides, low levels of HDL cholesterol,
hypertension, and elevated plasma glucose.

In the cross-sectional analysis, participants who reported having
higher levels of physical activity were younger, averaging 48 years old for men
and 51 for women, and had an overall more favorable cardiovascular risk profile
than those who were sedentary.

A total of 21 percent of women were classified as having metabolic
syndrome at baseline, as were 27 percent of men.

Significant differences were seen, however, in rates of metabolic
syndrome according to the degree of physical activity.

For example, the rate for sedentary men was 37 percent, falling to 14
percent for high levels of exercise, while the corresponding rates for women
were 31 percent and 11 percent, respectively.

In this analysis, the baseline risk for having metabolic syndrome was
lower for fast-paced walking in both men and women.

Risk also was reduced for jogging in men and women, but the adjusted
risk for increased duration of walking was not significantly reduced.

Heart rate was reduced from 76 beats per minute among sedentary men to
66 for those with high activity and from 75 to 69 among sedentary and active
women, respectively.

Those differences in heart rate reflected greater cardiorespiratory
fitness, according to the researchers.

After 10 years, an additional 15 percent of participants had developed
metabolic syndrome. Among those who were sedentary, the incidence was 19
percent compared with 12 percent of those who reported moderate to high physical
activity.

In the longitudinal analysis, along with brisk walking speed, jogging
also was associated with an adjusted lower risk for developing metabolic
syndrome, as was an overall high level of physical activity.

The researchers noted that the duration of walking did not appear to
lower the risk, but acknowledged that spending more time walking, even if at a
slower pace, could still have health benefits.

"If results can be corroborated by intervention studies showing
beneficial cardiovascular effects of increased walking speed, this may
represent a low-cost intervention with minimal side effects and numerous
significant health benefits," Prescott and colleagues concluded.

Limitations of the study included self-report of physical activity and
a lack of objective information about the duration and intensity of
activity.

In addition, no data were available for other potentially relevant
factors such as diet.

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